why is there amenorrhea or erectile dysfunction in acromegaly? pls explain anyone - USMLE Forums
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Old 02-10-2016
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Default why is there amenorrhea or erectile dysfunction in acromegaly? pls explain anyone

thanks in advance
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In acromegaly you have an over production of testosterone which causes feedback inhibition of FSH and LH. No FSH and LH will not cause that estrogen surge and therefore will not cause any ovulation or subsequent menstruation.

Its basically a concept of feedback inhibition. I'd look at testosterone and see what kind of effects and feedback inhibitions it has on the hypothalamus and pituitary to really solidify this concept.

If I missed any points or made any incorrect statements please let me know.

Thanks!
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Originally Posted by gogon 47 View Post
thanks in advance
the adenoma that is producing the excess GH is also compressing the surrounding tissues and this leads to decrease producation of LH/FSH which is cousing the amenorrea(or menstural irregularities) in females.

In males the erectile disfuction can be a cause of decreased testosteron becouse of the decreased LH/FSH, the decreased LH leads to decreased production of testosteron by leydig cells.
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macro adenomas produce mass effect on the surrounding resulting in compression of LH FSH secreting cells , also most adenomas that produce GH also produce some prolactin which depresses GnRH and LH FSH directly .
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i think differently, due to pressure effect of pituitary mass over the stalk, it disconnect the hypothalamus from the ant pituitary. therefore the inhibitory effect of dopamine over the ant pituitary is lost (dopamine is the main inhibition factor for prolactin) and the prolactin increases which causes loss of pulsatile release of GnRH and results in decreasing LH/FSH (both male & female) which ultimately causes amenorrhea & erectile dysfunction.
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Quote:
Originally Posted by gogon 47 View Post
i think differently, due to pressure effect of pituitary mass over the stalk, it disconnect the hypothalamus from the ant pituitary. therefore the inhibitory effect of dopamine over the ant pituitary is lost (dopamine is the main inhibition factor for prolactin) and the prolactin increases which causes loss of pulsatile release of GnRH and results in decreasing LH/FSH (both male & female) which ultimately causes amenorrhea & erectile dysfunction.
If the hypothalamus is disconnected from the pituitary then why you only lose the dopamin(which inhibited prolactin)and not also TSH,CRH...?
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